Zinc supplementation fails to increase the immunogenicity of oral poliovirus vaccine: A randomized controlled trial |
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| Institution: | 1. Aga Khan University, Karachi, Pakistan;2. WHO, Headquarters, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland;3. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA;4. National Institute of Health (NIH), Islamabad, Pakistan;1. Public Health Services, Ministry of Health, Jerusalem, Israel;2. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel;3. Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel;4. School of Public Health, Tel-Aviv University, Tel-Aviv, Israel;5. Viruses Branch, Centers for Disease Control and Prevention, Atlanta, USA;6. Israel Center for Disease Control, Ministry of Health, Tel-Hashomer, Israel;7. Southern District Health Office, Ministry of Health, Beer-Sheva, Israel;8. Department of Laboratories, Public Health Services, Ministry of Health, Jerusalem, Israel;9. Directorate, Ministry of Health, Jerusalem, Israel;1. Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad 45500, Pakistan;2. Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan;1. Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China;2. Beijing Center for Disease Control and Prevention, Beijing 100013, China;3. Chinese Center for Disease Control and Prevention, Beijing 100050, China;1. Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Enghlab Sq., Rafsanjan, Iran;2. Molecular Medicine Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran;3. Department of Immunology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran;4. Islamic Azad University of Flavarjan, Isfahan, Iran;5. Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;1. Department of Immunology, the Children’s Memorial Health Institute, Warsaw, Poland;2. Faculty of Electronics and Information Technology, Warsaw University of Technology, Warsaw, Poland;3. Department of Paediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, The Medical University of Bia?ystok, Bia?ystok, Poland |
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| Abstract: | BackgroundPolio eradication remains a challenge in Pakistan and the causes for the failure to eradicate poliomyelitis are complex. Undernutrition and micronutrient deficiencies, especially zinc deficiency, are major public health problems in Pakistan and could potentially affect the response to enteric vaccines, including oral poliovirus vaccine (OPV).ObjectiveTo assess the impact of zinc supplementation among infants on immune response to oral poliovirus vaccine (OPV).MethodsA double-blind, randomized placebo-controlled trial was conducted in newborns (aged 0–14 days). Subjects were assigned to either receive 10 mg of zinc or placebo supplementation daily for 18 weeks. Both groups received OPV doses at birth, at 6 weeks, 10 weeks and 14 weeks. Data was collected on prior immunization status, diarrheal episodes, breastfeeding practices and anthropometric measurements at recruitment and at 6 and 18 weeks. Blood samples were similarly collected to determine the antibody response to OPV and for micronutrient analysis. Logistic regression was used to determine the relationship between seroconversion and zinc status.ResultsOverall, 404 subjects were recruited. At recruitment, seropositivity was already high for poliovirus (PV) serotype 1 (zinc: 91.1%; control: 90.5%) and PV2 (90.0%; 92.7%), with lower estimates for PV3 (70.0%; 64.8%). By week 18, the proportion of subjects with measured zinc levels in the normal range (i.e. ≥60 μg/dL) was significantly greater in the intervention group compared to the control group (71.9%; 27.4%; p < 0.001). No significant difference in seroconversion was demonstrated between the groups for PV1, PV2, or PV3.ConclusionsThere was no effect of zinc supplementation on OPV immunogenicity. These conclusions were confirmed when restricting the analysis to those with measured higher zinc levels. |
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| Keywords: | Vaccine response Poliomyelitis Zinc supplementation Randomized controlled trial |
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